The correlation between structure and appearance is most straightforward when the skeleton is involved. Today’s case involved a young women after a motor vehicle accident more than a decade ago. The forehead was uneven, the brows in unequal position, old hardware palpable over the roof of the eye socket and the nose was crooked and […]
What is cosmetic surgery, what is reconstructive surgery, what is everything in between ?
All too often a difference is made between reconstructive and cosmetic surgery, most often to elevate the status of reconstructive surgery and lower the one of cosmetic surgery. I am a cosmetic surgeon and I do complex reconstrucive surgery. So I never could understand how someone could come up with something so artificial, neither based […]
Difficult Wrists
During my hand fellowship I once asked my program director Al Hess MD why he had become a hand surgeon after completing his training in orthopaedic surgery. His answer was “In the other stuff I had become so perfect that it was boring”. Wrist surgery is a prime example why hand surgery is never boring, […]
Six Packs and the Male Abdominal Wall
A not infrequent request by male clients is the “six pack” stomach and if there is a cosmetic procedure to enhance/produce it. The look of a “six pack” stomach is created by a very well trained midline muscle group – two about 10cm wide muscles on each side of the midline running from the chest […]
Specialist Treatment of Burn Injuries
The special expertise and training necessary to treat burn injuries is not widely available. Completion of a one year fellowship training in this area, as the lead surgeon of Trinidad Institute of Plastic Surgery has done 2001-2002 at the Tampa Bay Regional Burn Center, University of South Florida, is certainly desirable before embarking on the […]
Fronto-orbital advancement for correction of craniosynostosis
Numerous craniofacial deformities are characterized by orbital dystopia and anterior skull base deformities. Examples are Crouzon’s syndrome, Apert’s syndrome, coronal and metopic craniosynostosis. Two concepts developed by Paul Tessier (the father of craniofacial surgery) in the 1960’s are crucial to the understanding of the correction of these deformities. Firstly, the superficial skeleton of the eyesocket […]
A Cleft Pastiche
Aesthetic Craniomaxillofacial Surgery of the Midface
The techniques of skeletal surgery of the midface were originally developed to treat problems related to congenital and posttraumatic deformities affecting the occlusion. Occlusion – the way the upper and lower teeth come together – is determined by the position of the tooth bearing arches of the upper and lower jaws relative to each other. […]
Cleft Lip and Palate – Yardsticks for Perfection
Cleft lip and palate implies an often 20+ years rehabilitation process for the affected individual starting a few days after birth. The reward of this multistage, interdisciplinary process can be a near normal appearance. The luxury of this treatment in a global perspective is restricted to a privileged few in highly affluent countries. Children born […]
Writing for the gallery
It has been said that it is the secret dream of any surgeon to leave this world with his or her name attached to at least one instrument. This is what makes craniofacial surgery real fun as Paul Tessier had his name attached to almost all instruments on an average craniofacial surgery instrument tray. So […]